One of the toughest challenges for municipal governments in the Philippines has been to deliver sufficient primary health care services to people living in barangays far from the "bayan". The municipality of Sulat in Eastern Samar is no exception. For example, the main cause or monality prior to 1991 in isolated Barangay San Juan in Sulat was diarrhea. Only 30 percent of the 150 households had toilets.

In 1991, this situation began to change when Sulat became a pilot site of the Partnership for Community Health Development, a joint program of the Department of Health, the provincial and municipal governments, and the Eastern Samar Development Foundation, an NGO. That program is based on the principles that remote communities can and must lead in the management of their own preventive and primary health care; that economic and health problems and solutions are interrelated; and that partnerships between the community, NGOs, and government can help transform the health situation. Program managers chose to focus on Barangay San Juan.

All of the partners worked with the barangay to assess their problems and to conduct leadership and organizational training. Together, they built toilets, improved water sources and drainage, retrained midwives and barangay health workers, and constructed herbal and communal gardens. Trees have been planted to preserve the watershed.

Today, Barangay San Juan has no more deaths from diarrhea and there is a new attitude about health among the people. Consumer cooperatives have been set up, a feeder road has been built, and an electrification program will begin in July 1994. Sulat's government now plans to replicate the low-cost Partnership in Community Health and Development program in other barangays.

This program is recognized as a Trailblazing Program, a finalist for the 1994 Galing Pook Awards.